Data used for this study will consist of cardiac surgery data from the Cleveland Clinic Foundation Cardiovascular Information Registry (CVIR). Four cohorts of data will be assembled; Cohort I: 18,914 CABG patients between 1990 and 2000; Cohort II: 6952 patients undergoing aortic valve replacement; Cohort III: 2979 patients undergoing mitral valve replacement; Cohort IV: 10,482 patients undergoing mitral valve repair. The primary endpoint will be long term total mortality; for valve surgery patients it will be active follow-up.